Help Stop TB in Their Lifetime

By Meg Carter, ChildFund Sponsorship Communications Specialist

Tuberculosis is rare today in the United States and other developed countries, but in developing nations, it is a killer. Globally, TB has created 10 million orphans and is one of the top-three causes of death in women ages 15 to 44.

Today, March 24, we mark World TB Day by joining with the World Health Organization (WHO), the Centers for Disease Control and other international organizations to raise awareness and mobilize political and social commitment toward progress in the care and control of tuberculosis.

children in Sierra Leone

Sierra Leone has the world’s highest tuberculosis incidence and mortality rates by far.

Caused by an airborne bacteria, TB often attacks lungs and has developed strains that are resistant to multiple drug treatments. It also strikes people with weak immune systems, particularly those infected with HIV. In the 1800s, Western Europe saw the number of tuberculosis deaths peak at nearly 25 percent, but with better medical treatment and understanding, the TB mortality rate fell by 90 percent by the 1950s.

Now, as the virus mutates and resists standard drug therapies, developing nations are experiencing the same level of risk as Europe did a century ago. This year marks the second half of WHO’s two-year campaign Stop TB in My Lifetime, a program that is significant to countries ChildFund serves in Africa and Asia.

Globally, tuberculosis is second only to AIDS as the greatest killer from a single infectious agent. At least a third of HIV-infected patients worldwide are also diagnosed with TB, and in Sub-Saharan Africa, tuberculosis is often the infection that is directly responsible for death. In fact, testing positive for tuberculosis often masks HIV-positive status, which makes proper medical treatment far more difficult than for patients who have one disease or the other.

Ugandan girl holds memory book

In Uganda, TB and HIV infections are often combined, making treatment difficult. This child holds a memory book her HIV-positive parents created for her.

Despite the overall decline worldwide in incidences of TB and the development of rapid diagnostics, the combination of HIV and TB and its accompanying challenges have kept Africa from being on track to halve its tuberculosis deaths by 2015, a WHO goal.

WHO estimates that 500,000 children were newly infected in 2011, and 64,000 died. Tuberculosis is particularly difficult to diagnose in children; current TB tests are largely inaccurate for children.

Poor communities and vulnerable populations also suffer disproportionately from TB. At highest risk are young adults, infants, diabetics, smokers, those infected with HIV, people who are malnourished and anyone living in crowded or unclean conditions — such as refugees and others displaced by a natural disaster, political oppression or civil unrest.

Because TB threatens the well-being of children where we work, ChildFund supports local government initiatives and public messaging. Here are some facts about ChildFund-supported countries and their exposure to TB:

Sierra Leone has the world’s highest prevalence and mortality rates; tuberculosis incidence there is one and a half times as high as in the second-ranked country, and Sierra Leone’s mortality rate is almost twice as high.

mother and child in a Timor-Leste garden

Timor-Leste has the world’s eighth highest incidence rate of TB, but good nutrition can make families less vulnerable to infection.

Cambodia ranks fifth for prevalence and Timor-Leste eighth, but both countries tie for fifth-highest mortality rate because Cambodia has an edge in successful treatment.

Joining those three nations as very-high-incidence countries are The Gambia, Liberia, Mozambique, the Philippines and Zambia.

Areas of high prevalence include Afghanistan, Ethiopia, Guinea, India, Indonesia, Kenya, Thailand, Uganda and Vietnam. Uganda, where TB and HIV infection forms a lethal combination, has a treatment success rate of only 71 percent.  Ethiopia and Guinea also have lower-than-average success rates: 83 percent and 80 percent, respectively.

The story isn’t entirely bleak, though. Some countries have made impressive progress. Between 1995 and 2011, 85 percent of all new infections and 69 percent of relapsing cases were successfully treated. And between 1990 and 2011, the overall mortality rate fell by 41 percent.

However, every year funding falls $3 billion short of WHO’s goal to make quality care accessible regardless of gender, age, type of disease, social setting or ability to pay. International assistance is especially critical for the 35 countries designated as low-income — including Afghanistan, Cambodia, Ethiopia, The Gambia, Guinea, Kenya, Liberia, Sierra Leone, Mozambique and Uganda. Of these, The Gambia, Guinea and Sierra Leone are not currently among the top 50 recipients of Official Development Assistance.

Please join us in taking action to end the burden of tuberculosis in the lifetimes of the children we serve. When you sponsor a child or make a donation to Children’s Greatest Needs, you’ll be helping to ensure that children in our programs live healthier lives.

Children and Tuberculosis: A Neglected Demographic

Today is National Tuberculosis Day, and our guest bloggers provide critical information about this disease that is a leading cause of death in children.

by Neda Dowlatshahi and Rachel Hampton, research associates, Global Health Council

Of about 9 million cases of TB that occur annually, about 1 million occur in children under age 15. In some developing countries, children account for up to 25 percent of cases. TB causes more than 40,000 deaths among children under age 5 each year. Typically, TB progresses more rapidly and is more severe in younger children; it also contributes to the high burden of childhood pneumonia.

TB is aptly described as “a disease of poverty,” as it infects millions of children in poor living conditions. Malnutrition, food insecurity, HIV infection, overcrowding, and a less-developed immune system are among the factors that put children at risk and may also increase the rate of disease progression.

TB is often transmitted to children by their mothers, as TB is the third leading cause of death of women age 15-44. Although providing treatment to family members may avert thousands of pediatric infections, studies have shown that even if you increase treatment of adult TB, many children would continue to die from the disease. Nonetheless, integrating pediatric TB services into broader maternal and child health intervention packages would be an efficient way to ensure that children received the care they need.

In terms of prevention and treatment for children, the BCG vaccine should be given soon after birth, as it can help to prevent TB meningitis. A new, cost-effective TB vaccine could reduce childhood TB infections. Caregiver education is also critical to ensure proper prevention and treatment.

Not only are children at risk of infection, but they are at risk of becoming orphans – in India alone, 300,000 children are orphaned every year due to TB. In many developing countries, orphans face increased stigmatization and discrimination in society, which may hinder their access to services and future educational and employment opportunities.

When family members are infected, children are often obliged to work to provide food and income. This forces children out of school, affecting their education and future employment opportunities.

So, why aren’t we paying more attention to pediatric TB? Some speculate that more attention is placed on prevention and treatment for adults since children are rarely contagious. Another reason is that the diagnostics and research studies are limited. Whatever the reasons, we need to do a better job in preventing and treating pediatric TB.

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